As noted earlier, the majority of recipients remain in AOT longer than the initial court order period of six months, with the average total length of time in AOT being 16 months. To assess outcomes for these individuals over their entire course of AOT, OMH continues to collect evaluation data at six month intervals until AOT program termination. This section discusses AOT recipient outcomes achieved over the entire course of court-ordered treatment.

During the entire time of participation in AOT, large decreases in the incidence of hospitalization, homelessness, arrest and incarceration are seen for recipients when compared to pre-AOT levels. Table 10 and Figure 5 summarize change in the occurrence of these events. Three years prior to AOT, 23% of AOT recipients had at least one incarceration. While in AOT, only 3% of recipients experienced an incarceration, a decrease of 87%. Over the same time comparison, the incidence of arrest, psychiatric hospitalization, and homelessness declined 83%, 77%, and 74%, respectively.

OMH evaluation staff examined changes in the total number of days individuals spent hospitalized before, during and after AOT. On average, AOT recipients spent 50 days hospitalized for psychiatric care during the six months prior to court-ordered treatment. While receiving court-ordered treatment, recipients’ days hospitalized dropped to an average of 22 days per six month period, a reduction of 56%. Days hospitalized continued to decline even after the end of court-ordered treatment: during the first six months after termination of the court order, total days hospitalized dropped to an average of 13 days, a reduction of 74% from the pre-AOT total (Figure 6).

On average, AOT recipients continued to experience gains in social and community functioning and reductions in harmful behaviors throughout the duration of court-ordered treatment (Figure 7). Gains made during the initial six months of AOT were retained over time, and on some measures additional improvement occurred after the first six months. For instance, by the end of court-ordered treatment, 27% of AOT recipients achieved a substantial improvement in overall functioning (defined as a 10 point or greater gain on the GAF). Figure 8 below compares the percent reduction in harmful behaviors for recipients who leave AOT after six months versus recipients who remain in AOT longer than six months. As the chart shows, both groups experience a nearly identical reduction during the initial six month period following the court-order. The group remaining in AOT experiences further reductions in harmful behavior during their remaining time under court-order; however, these changes are smaller in magnitude than the declines experienced during the initial six month period.

Figure 7

Figure 8

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